Did you know that colorectal cancer was one of the most preventable types of cancer and the most treatable type of cancer if caught early? It is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in the U.S. in both men and women. Colorectal cancer is usually a disease of older adults over 50. Did you know that according to Memorial Sloan Kettering, more people under 50 years old have been diagnosed with colorectal cancer in recent years, specifically people who are in their 20s and 30s?
Who What and How?
Who is affected by colorectal cancer? What are the risk factors? What are the screening options and how is this cancer prevented. The Colorectal Cancer Alliance, a non-profit organization that was started by a group of colorectal survivors and caregivers in 1999 has a new prevention campaign. It is called “ Don’t Assume”. This campaign focuses on educating the public on the signs and symptoms of colorectal cancer and challenges old beliefs about the disease. Their mantra is “when people Don’t Assume” lives can be saved!
Who is at Risk for Colorectal Cancer?
People with a strong family history of colorectal cancer or certain types of polyps.
People with a personal history of colorectal cancer or certain types of polyps.
A personal history of inflammatory bowel disease, e.g: ulcerative colitis or Crohn’s Disease.
A person who has a known family history of hereditary colorectal cancer syndrome, such as Lynch Syndrome (hereditary non-polyposis colon cancer HNPCC).
A person with a history of radiation to the abdomen or pelvic area.
Signs and Symptoms
Early signs of colorectal cancer include:
Change in bowel habits, such as diarrhea, constipation or change in consistency of the stool.
Persistent abdominal discomfort, e.g.: cramps, gas or persistent feeling of being full.
Rectal bleeding- bright red blood in the stool, or dark sticky stool.
Weakness or fatigue – weight loss for no reason, nausea and vomiting.
See your physician if you have any of these signs for further screening or testing.
Screening and Early Detection
Early detection and screening are key. The earlier the disease is found and removed or treated the better the outcomes for the individual. Screening for colorectal cancer saves lives. An individual’s risk factors such as ethnicity, lifestyle, and family history have an impact on when screening should begin.
So you may be asking yourself when should I start to get screened for colorectal cancer? The American Cancer Society recommends that adults without a family history of colorectal cancer begin at age 45. If you have a family history of colorectal cancer, any risk factors or any signs and symptoms of the disease, screening starts at 45 years. In March of 2018, Memorial Sloan-Kettering opened The Center for Young Onset Colorectal Cancer. This was in response to the increase in colorectal cancer in people under 50 years of age.
Screening Tests
Screening for colorectal cancer can be broken down into two categories, stool-based screening tests, and visual (structural) screening tests.
Stool-based screening tests include:
Fecal Immunochemical Test (FIT) – tests for blood in the stool, swab stool, and place on the card, done annually. Requires 1-2 samples.
Guaiac Fecal Test- test for occult blood in the stool, done annually.
Multi-targeted stool DNA test- this newest form of testing is FDA approved and offers to not only detect hemoglobin in the stool but abnormal DNA, which is present in pre-cancerous or cancerous growths. This test is recommended every three years.
Visual (structural) screening tests include:
Colonoscopy- uses a scope to visualize the colon. A bowel prep is required. Recommended every 10 years or sooner depending on risk and previous finding of polyps in the colon.
CT colonography- virtual colonoscopy, a scan of the colon that produces two-dimensional images.
Sigmoidoscopy-not used as frequently for colorectal screening, since it does not look at the entire colon, but it can be used. If polyps are found, a colonoscopy is recommended.
Prevention Strategies
The American Cancer Society stresses maintaining a healthy lifestyle, which includes eating a diet low in animal fats and high in fruits and vegetables and regular exercising as key prevention tips.
The Colorectal Cancer Alliance in their “Don’t Assume” Campaign is increasing education and awareness about colorectal cancer for all ages through their posters and social media tool-kits for organizations and companies. Their mission is to get the message out to all age groups and genders to help stop this disease – one of their mantras is “when people Don’t Assume” lives can be saved!!!
References:
1.https://www.cancer.org/latest-news/understanding-tests-that-screen-for-colon-cancer.html
3. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html
4. https://www.ccalliance.org/about/awareness-month/awareness-materials
Incidence & Survival
This year The American Cancer Society estimates that over 95,000 people will be diagnosed with colon cancer. The estimate is that over 50,000 people will die from the disease. The five-year survival rate, as documented by the American Cancer Society is based on if the disease is local, regional or distant. If the disease is local, meaning it is limited to the colon, there is a 90% survival rate, regional meaning it is spread to the lymph nodes, a 71 % survival rate and distant meaning it has spread to other organs, a 14% survival rate. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html